MEDICARE: DR. MICHELE LYNN GASPER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	MD60496544	WA

General Provider Information

NPI Number	:	1639151293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELE LYNN GASPER MD

Provider Business Mailing Address
First Line	:	275 SE CABOT DR
Second Line	:	SUITE B-102
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-3715
Country	:	US
Telephone Number	:	360-675-5555
Fax Number	:

Provider Business Practice Location Address
First Line	:	275 SE CABOT DR
Second Line	:	SUITE B-102
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-3715
Country	:	US
Telephone Number	:	360-675-5555
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	01/28/2016

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